Posted by Bill Sandweg on 13 November 2023.
One of the complaints doctors often make is that the existence of so many frivolous medical malpractice suits forces them to practice defensive medicine. By this they mean that the worry of a potential lawsuit makes them order tests or do other precautionary things that are of no benefit to the patient, but which can help them, if they were ever to be sued by the patient. I say this is BS.
Our American health system runs primarily on what is called fee for service. A doctor who performs a service is paid for that service. If the doctor does not perform a service, the doctor does not get paid. When a doctor orders a test, the results of that test must be reviewed and analyzed. It may require another office visit by the patient so the doctor can review the test results with the patient. The doctor may even do the tests in the office and receive a fee for performing the test. As everyone can see, ordering a test results in the doctor earning a fee. The more tests, the more fees. Is it any wonder doctors order lots and lots of tests? Is it any wonder that as they rake in the money, they blame the legal system and the lawyers for making them do it?
Doctors do get sued from time to time. As I pointed out last week, they get sued far less than one would expect, given the amount of malpractice that occurs. Some doctors go their entire careers without ever being sued. When they do get sued, doctors win 85% to 90% of the time. They don’t need to have ordered every test in the book or to have performed unnecessary interventions to protect themselves in the event of a lawsuit. They do it because it puts money in their pockets.
In lamenting the fact that they are forced by the legal system to practice defensive medicine, doctors never mention that to do so is to violate the code of medical ethics they profess to hold so dear. One of the most important of the ethical principles is that the patient comes first. The doctor may not do things which benefit the doctor, if they are not in the best interests of the patient. To order tests that the patient does not need because the doctor claims to be afraid of getting sued, is a violation of medical ethics. To perform an unnecessary intervention or procedure on a patient because the doctor claims to be afraid of getting sued, not only exposes the patient to the risk of the procedure, it is a violation of medical ethics.
Complaints by doctors that they are forced by the legal system to practice defensive medicine is just another part of the campaign by the medical profession to persuade the public that they are the good guys and that the legal system is biased against them. The statistics show that nothing could be further from the truth. Doctors are highly respected and juries give them every benefit of the doubt, as evidenced by their win rate in court. They don’t need to practice defensive medicine and they don’t need to blame the legal system for their unethical behavior.